Monday, April 16, 2018

Italians have never been much for
Calvinist-type frugality. The Catholic hierarchy’s response to Luther’s 16th
century revolt was a Counter-Reformation construction boom which aimed to woo back
the faithful by dazzling them with ever more lavish churches. Rome’s Gesù is a
prime example, with its dazzling colored marbles, swooping angels, and
mouth-watering lapis lazuli columns. Same thing for clothes. Where my
generation of American girls were taught to underdress – “look in the mirror
before you go out, and remove one piece of jewelry” – Italian ragazze would toss on an extra necklace.

Public hospitals in Rome are shabby
and General Practitioner offices run to the bare-bone, but in one medical niche
the glitz principle holds: the vast private system. A ghostly for-profit shadow
hovers alongside the National Health Service, complete with its own doctors
(including me), laboratories, and hospitals. A private casa di cura or clinica will
have an atrium decked out in Ficus benjamina, oil paintings, and design
furniture, and rooms with disposable slippers and a comfy sleep-on couch for
your spouse. A Italian patient of mine, exposed to the private system for the
first time, cast his eyes around and said in wonder, “My God, this hospital’s
so clean.”

Once you get past the glitter, Rome cliniche usually offer a narrow range of
medical services. One may concentrate on childbirth, another on cancer, a third
on cardiac catheterization, none covering all the bases and most preferring
elective rather than emergency procedures – think hotels with operating suites.
Here and there you’ll find a small intensive care unit, but they never have a
real Emergency Room. A couple claim to cover emergencies 24/7, but the one time
a patient of mine tested that boast the hospital flunked: she showed up with an
asthma attack, something anyone with a medical degree should be able to handle,
and was sent home without being examined much less treated because they “didn’t
have the right specialist.” As the locals say with ironic intent, Tanto siamo in Italia, What can you do,
we’re in Italy.

Wednesday, April 4, 2018

After a decade of
widowhood my ex-mother-in-law, Mariada, finally made a visit to the Italian telephone
company offices to change her account from her late husband’s name to her own. Employee:
“If you want to change the name, Mario has to endorse it. You can just sign his
name here.” Mother-in-law: “I can’t sign it for him, he’s been dead for ten
years.” Employee, helpfully: “Why don’t you step outside with the form and sign
it in the corridor? When you come back in I’ll pretend it’s the first time I’ve
seen you.”

Glossary: infrazione

A petty violation of the law. A colleague
was explaining the route to drive to the University: "You drive down Via
del Quirinale to Largo Santa Susanna, and then… no, you're too American, you
can't." "Can't what?" "Well, then you have to make a
slightly illegal left turn, a small infrazione,
it's the only way to get there."

Italian rules often seem made to be
broken, but they can turn inflexible when you least desire it. I
helped a schizophrenic
patient through infinite red tape to get an Italian disability pension, a
welcome supplement to his meager wages from a manual job an hour’s drive from
home. One week after he received his first pension check he was notified that
now that he had been certified as disabled his driver’s license had been
automatically revoked.

The casual lawlessness rubs off on
you. I shocked a friend by distractedly bypassing a dozen cars waiting at a
California tollbooth and sneaking back into the line. I shocked myself by
swearing to the State of New York I’d lost my drivers license when I’d actually handed it in to
the authorities here in return for an Italian one. I shocked my mother by
suggesting over the phone she sign my name to a jury duty summons; once she’d
recovered, though, she said what the hell and practiced my signature until she
could forge it on the dotted line, savoring the glee of transgression after 65
years of walking the straight and narrow.

Italians’ behavior is governed by the
ad hoc and the ad personem. They consider Americans’ reliability to be
rigidity, our rules to be unwarranted limits on options, our planfulness a
brake on spontaneity, our constant pleases and thank yous a defense, our lofty
ethical precepts hypocritical cop-outs geared to avoiding immersion in the complexities
of human relations. Romans prefer a “half date,” a mezzo appuntamento, to a definite one, and they don’t hesitate to
cancel at the last minute if they’re feeling tired or antisocial. When I told a
friend this seemed rude, he said an unwilling dinner guest wouldn’t be fun
anyway.

Italians disdain rule-worshippers just
as illiterate people disdain those who can’t remember anything if they don’t
write it down. My friend Daniela once made a U-turn on an empty small-town
street in Switzerland. A woman leaned out her second-floor window and yelled a
reprimand. Daniela – who hails from Italy’s relatively law-abiding North –
responded by making another U-turn, then another, then another… Italians are great
at improvisation and seat-of-your-pants, farm by the phases of the moon when
they’re not designing Maseratis, and always feel more secure having a low-tech
backup. They wear a condom but pull out anyway. They shine during Third-World
travel: when things go wrong, stick with the Italians, who get busy devising a
fix while the Americans are sitting around waiting for the authorities to show
up. Neapolitans call it l’arte di
arrangiarsi, the art of muddling through.

There are traffic lights in Rome
deemed unnecessary by popular opinion. You’ll be honked at if you stop.

About Me

I moved to Rome in 1978 after finishing my training in New York, and have been practicing primary care internal medicine there ever since, treating a clientele that’s featured Roman auto mechanics and British ambassadors, Indonesian art restorers and Filipina maids, Russian poets and Ethiopian priests. When not seeing patients, doing research in psychosomatic medicine, or being the Artist's Wife to my composer husband, I've written a book about my medical adventures, Dottoressa: An American Doctor In Rome, to be published by Paul Dry Books in May 2019.